REVIEW – November 2007

Incidence of testicular cancer in Estonia 1970–2004


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Introduction. Testicular cancer (TC) is a common malignancy among young men. The incidence is increasing worldwide. TC is a highly curable cancer today, although the aetiology is unclear.
Objective. The paper provides an overview of the incidence and time trends of TC in Estonia during 35 years.
Material and methods. Data from the Estonian Cancer Registry were used for analysing the incidence. Time trend was estimated as the ratio of incidence rate of the last (2000–2004) to the first (1970–1974) five-year period of diagnosis.
Results. A total of 449 new cases were diagnosed in 1970–2004. TC accounted for 0.6% of all incident cancer cases in males. The age standardised (world) incidence rate per 100 000 increased from 0.9 to 2.7 (rate ratio 3.0; 95% CI 2.0–4.5). The most pronounced rise was observed for the age group 15–29 years. Seminoma accounted for 55% and non-seminoma for 38% of the cases. The mean age of the patients at  diagnosis was 40 years for seminoma and 28 years for non-seminoma. In 1995–2004, TC was diagnosed in the localised stage in 47% of the patients, while distant metastases were found in 29% of the patients. Nonseminoma was diagnosed at a significantly higher stage than seminoma. Right-sided TC occurred more frequently than left-sided TC.
Discussion. The incidence of TC is increasing in Estonia; however, the rates are lower than in the Nordic countries. The basic characteristics of the patient population (breakdown by age, tumour histotype and laterality) are similar in Estonia and other European countries. The relatively high proportion of advanced tumours in Estonia could have contributed to the low survival rates revealed by the EUROCARE study. While modern diagnostic and treatment methods are available in Estonia today, further improvement in TC management depends on earlier detection.